You will have to identify a problem or need in your organization or place of employment. You will have to identify an area for improvement, to either eliminate or reduce waste, improve workplace appreciation, or strengthen leadership.
The following steps will guide you through the A3 Process. To get a more in-depth explanation of the step, the explanation on the step is included below.
• Step 0: Identify a problem or need
• Step 1: Conduct research to understand the current situation
• Step 2: Conduct root cause analysis
• Step 3: Devise countermeasures to address root causes
• Step 4: Develop a target state
• Step 5: Create an implementation plan
• Step 6: Develop a follow-up plan with predicted outcomes
The results of steps 0-6 can be recorded on an A3 report. See the report form attached.
STEP 0: Identify Problem or Need
Whenever the way work happens is not ideal, or when a goal or objective is not being met, you have a problem (or, if you prefer, a need). The best problems to work on are those that arise in day-to-day work and prevent you from doing your best.
EXAMPLE: Patients in a hospital were not arriving to the diagnostic departments during their allotted time. Because the patients were late, the diagnostic departments were getting backed up. Thus the problem to be addressed was: reducing patient back-ups in the hospital’s diagnostic departments due to late arriving patients.
STEP 1: Understand Current Situation
Before a problem can be properly addressed, one must have a firm grasp of the current situation. To do this, Toyota suggests that problem-solvers:
• Observe the work processes first hand, and document one’s observations.
• Create a diagram that shows how the work is currently done. Any number of formal process charting or mapping tools can be used, but often simple stick figures and arrows will do the trick.
• Quantify the magnitude of the problem (e.g., % of customer deliveries that are late, # of stock outs in a month, # of errors reported per quarter, % of work time that is value-added); if possible, represent the data graphically.
STEP 2: Root Cause Analysis
Once you have a good understanding of how the process (i.e., the one that needs to be fixed) currently works, it’s time to figure out what the root causes are to the errors or inefficiency. To accomplish this, first make a list of the main problem(s). Next, ask the appropriate “why?” questions until you reach the root cause. A good rule-of-thumb is that you haven’t reached the root cause until you’ve asked “why?” at least five times in series.
EXAMPLE: A team trying to improve patient transport processes recognized that the main problem was that patients were not arriving on time for their diagnostic procedures, causing severe back ups in the diagnostic departments. In this case, three causes to patients arriving late were identified by observation, and each was pursued to a root cause, as shown below.
Problem: Backups in diagnostic departments
Why? Patients arriving late
Why? Transporter not called on time
Why? Ward secretaries are busy and often forget.
Why? No written message
Why? No protocol
Why? Transport unable to locate patient
Why? Page does not include patient location (name only)
Why? No standard protocol for transport paging
Why? Patient not ready for transport
Why? Nurses unaware of prescribed test
Why? No mechanism to inform RN of scheduled procedure
The root cause analysis revealed that patients were arriving late because the hospital had no procedure for notifying appropriate personnel of a transportation need, and that transporters and RN’s were not contacted directly by the requesting department.
STEP 3: Countermeasures
Once the current situation is fully understood and the root cause(s) for the main problem(s) has been unveiled, it’s time to devise some countermeasures. Countermeasures are the changes to be made to the work processes that will move the organization closer to ideal, or make the process more efficient, by addressing root causes. Generally speaking, we recommend that countermeasures help the process conform to three “rules”.
• Specify the outcome, content, sequence, and task of work activities
• Create clear, direct connections between requestors and suppliers of goods and services
• Eliminate loops, workarounds, and delays
EXAMPLE: The team investigating delayed transport of patients to diagnostic departments discovered that the root cause was lack of clear protocol for communicating between the diagnostic department, RN of the clinical department, and the transporter. To fix this problem, they came up with some countermeasures that included:
• A new protocol where the diagnostic department pages the charge RN and the transporter at the same time (thus eliminating the ward secretary as an intermediary).
• Specified information content of pages.
• New patient preparation procedures involving both the RN (or technician designated by the RN) and the transporter
STEP 4: Develop the Target State
The countermeasure(s) addressing the root cause(s) of the problem will lead to new ways of getting the work done, what we call the target condition or target state. It describes how the work will get done with the proposed countermeasures in place. In the A3 report, the target condition should be a diagram (similar to the current condition) that illustrates how the new proposed process will work. The specific countermeasures should be noted or listed, and the expected improvement should be predicted specifically and quantitatively.
STEP 5: Implementation Plan
In order to reach the target state, one needs a well thought-out and workable implementation plan. The implementation plan should include a list of the actions that need to be done to get the countermeasures in place and realize the target condition, along with the individual responsible for each task and a due date. Other relevant items, such as cost, may also be added.
EXAMPLE: An example of a simple implementation plan is below. Note that the task, the person responsible, deadlines and the outcome of the tasks are all specified.
STEP 6: Follow-up Plan
A critical step in the learning process of problem-solvers is to verify whether they truly understood the current condition well enough to improve it. Therefore, a follow-up plan becomes a critical step in process improvement to make sure the implementation plan was executed, the target condition realized, and the expected results achieved. You can state the predicted outcome here rather than in the target condition, if you prefer.
EXAMPLE: The manager of transportation, and head of the A3 process team, set the goal for patient transport time at 30 minutes, maximum. Once a month, for three months after the initial implementation, he would measure a sample of transportation pages, and calculate the average time from transportation page to patient arrival at the diagnostic department.
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